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Is this fracture care?

  1. #1
    Location
    Daytona Beach, FL
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    746
    Exclamation Is this fracture care?
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    Any help I could get with this would be apprecaited!

    I have been coding an ortho's surgical charts, but now they are missing charges for their office visits and hospital visits and have asked me to do an audit. I have found that the office has somehow missed billing a slew of charges for fracture care and initial E/M and has just been posting the follow up visits as post op, no charge. I am going through these accounts to see what charges are missing and have a few questions since I usually don't do the office charges.

    1. If the patient was seen as an inpatient for say a pelvic fracture and no surgery is done or manipulations or casting (or any other fracture that nothing physically was performed), but the doctor follows the patient in the hospital and then as OP, would this still be considered fracture care or would I bill each indiviual E/M?

    2. From the patient history in billing, the doctor saw the patient for the initial care, but I do not show any other visits posted - would I still bill for fracture care if the patient never returned for follow up visits (assuming it was the patient's decision not to return)?

    3. Fracture care includes the first cast, however if the cast needs to be replaced during the global period, how would this be billed? Which codes would be used and/or casting supplies billed?

    Thanks for any help with this - I have to meet with the Ortho office tomorrow and I would like to go in there with some knowledge of what to tell them.
    Jodi Dibble, CPC

  2. Default
    Quote Originally Posted by jdibble View Post
    Any help I could get with this would be apprecaited!

    I have been coding an ortho's surgical charts, but now they are missing charges for their office visits and hospital visits and have asked me to do an audit. I have found that the office has somehow missed billing a slew of charges for fracture care and initial E/M and has just been posting the follow up visits as post op, no charge. I am going through these accounts to see what charges are missing and have a few questions since I usually don't do the office charges.

    1. If the patient was seen as an inpatient for say a pelvic fracture and no surgery is done or manipulations or casting (or any other fracture that nothing physically was performed), but the doctor follows the patient in the hospital and then as OP, would this still be considered fracture care or would I bill each indiviual E/M?

    2. From the patient history in billing, the doctor saw the patient for the initial care, but I do not show any other visits posted - would I still bill for fracture care if the patient never returned for follow up visits (assuming it was the patient's decision not to return)?

    3. Fracture care includes the first cast, however if the cast needs to be replaced during the global period, how would this be billed? Which codes would be used and/or casting supplies billed?

    Thanks for any help with this - I have to meet with the Ortho office tomorrow and I would like to go in there with some knowledge of what to tell them.
    1. NO fracture care
    2. Yes fracture care if dr actually performed some kind of evaluation of the fx and the first cast or splint application.
    3. ex. if this was a Short arm cast I would bill 29075-58 with Q4010 but no Office visit, it would be post op 99024.

    That is my opinion on what I would do.

  3. #3
    Location
    Long Island/New York
    Posts
    1,271
    Default
    Quote Originally Posted by jdibble View Post
    Any help I could get with this would be apprecaited!

    I have been coding an ortho's surgical charts, but now they are missing charges for their office visits and hospital visits and have asked me to do an audit. I have found that the office has somehow missed billing a slew of charges for fracture care and initial E/M and has just been posting the follow up visits as post op, no charge. I am going through these accounts to see what charges are missing and have a few questions since I usually don't do the office charges.

    1. If the patient was seen as an inpatient for say a pelvic fracture and no surgery is done or manipulations or casting (or any other fracture that nothing physically was performed), but the doctor follows the patient in the hospital and then as OP, would this still be considered fracture care or would I bill each indiviual E/M?

    2. From the patient history in billing, the doctor saw the patient for the initial care, but I do not show any other visits posted - would I still bill for fracture care if the patient never returned for follow up visits (assuming it was the patient's decision not to return)?

    3. Fracture care includes the first cast, however if the cast needs to be replaced during the global period, how would this be billed? Which codes would be used and/or casting supplies billed?

    Thanks for any help with this - I have to meet with the Ortho office tomorrow and I would like to go in there with some knowledge of what to tell them.
    1. Looks like just E/M since nothing was done (x-ray, casting, manipulation, etc.) for the patient.

    2. Fracture care includes and needs follow-up visits as the fracrure care payment includes post-op E/M's in the payment.

    3. You can change the cast with supplies (if done in office setting). I use 58 modifier. There's a great AAOS article on fracture care and good CPT Assistant article on cast removal/supplies. Send your email and I'll send over to you.
    KM

  4. Default
    KM, can you send me the article regarding fx care? scottac@health.missouri.edu Thanks! Angie

  5. #5
    Default
    will you please send me the article too? Thank you! dbrandt@meriter.com

  6. Default Me, too, please!
    I'd be interested in that information also. Can you please send it to me - cphipps@booneortho.com ? Thanks so much!

  7. #7
    Default
    Me - too. Please!
    I'd also be interested in this article. Fracture care and recasting always brings up questions.

  8. #8
    Default
    Sorry - forgot email address
    diane_eslinger@rsh.net

  9. #9
    Default
    Quote Originally Posted by nyyankees View Post
    1. Looks like just E/M since nothing was done (x-ray, casting, manipulation, etc.) for the patient.

    2. Fracture care includes and needs follow-up visits as the fracrure care payment includes post-op E/M's in the payment.

    3. You can change the cast with supplies (if done in office setting). I use 58 modifier. There's a great AAOS article on fracture care and good CPT Assistant article on cast removal/supplies. Send your email and I'll send over to you.
    KM
    Could I also be sent the link/article from AAOS and CPT Assistant? Thanks so much!
    malexander@mainegeneral.org

  10. Default Me too
    Please send the article to me as well. mhhobbins@gmail.com

    Thanks~

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